Benefits
Lower HbA1c and blood insulin over 12 weeks
In a 12-week placebo-controlled trial in adults with type 2 diabetes, taking the enzyme at 300 or 900 mg a day with meals lowered HbA1c by about 0.18 to 0.21 percentage points and lowered blood insulin compared with placebo. The changes were small, came from a single research group, and the enzyme maker took part in the work.
Smaller LDL cholesterol and triglyceride readings over 12 weeks
In the same 12-week trial, both enzyme doses lowered LDL cholesterol by about 0.17 to 0.22 mmol/L versus placebo, and the higher dose also lowered triglycerides and diastolic blood pressure. Body mass index and liver enzymes rose in the placebo group but not with the enzyme. These are single-trial findings.
Produces prebiotic fiber in the gut from dietary starch
Working in the digestive tract, the enzyme rearranges some sugars and starch from a meal into isomaltooligosaccharides, a prebiotic fiber, in place. Laboratory work shows these oligosaccharides resist stomach acid and digestive enzymes and feed gut bacteria, though shorter ones are still slowly broken down to glucose in the small intestine.
Shifts gut microbiota and short-chain fatty acids
In two 12-week trials in adults with type 2 diabetes, the enzyme changed the makeup of gut bacteria, raising the Bacteroidetes-to-Firmicutes ratio, and altered fecal short-chain fatty acids such as acetate. These are changes in gut bacteria and fermentation markers, not proven health outcomes, and come from one research group.
More regular bowel movements in some people
In a 12-week trial in adults with type 2 diabetes, the enzyme improved bowel movements compared with placebo among those who began with sluggish bowels, alongside a rise in fecal acetate. People without bowel trouble at the start saw no change. The study was small and described by its authors as preliminary.
Mechanism of action
Rearranges meal starch into isomaltooligosaccharides
As dietary starch is broken down to malto-oligosaccharides and maltose, transglucosidase transfers glucose units onto them to form alpha-1,6 bonds, converting them into isomaltooligosaccharides. Those alpha-1,6 linked sugars are harder for human digestive enzymes to break down than the original alpha-1,4 starch.
Acts in the gut, not the bloodstream
The swallowed enzyme works on the carbohydrate inside the digestive tract and is not absorbed to act elsewhere in the body. The oligosaccharides it makes travel on to the colon, where resident bacteria ferment part of them into short-chain fatty acids such as acetate.
Lowers the sugar released from a meal
By shunting some digestible starch and maltose into less-digestible isomaltooligosaccharides, less glucose is released and absorbed after a meal. This was seen as lower post-meal blood glucose in diabetic dogs and as a smaller glycemic response to synthesized long-chain isomaltooligosaccharides in mice.
Clinical trials
Randomized, double-blind, placebo-controlled 12-week trial of oral transglucosidase at 300 or 900 mg/day in patients with type 2 diabetes; an author was from the enzyme maker Amano Enzyme. (Sasaki et al. 2012, Diabetes Obes Metab)
Adults with type 2 diabetes mellitus.
Versus placebo, both doses lowered HbA1c (by 0.18 and 0.21 percentage points) and blood insulin, and lowered LDL cholesterol by about 0.17 to 0.22 mmol/L; 900 mg/day also lowered triglycerides by 0.24 mmol/L and diastolic blood pressure by 8 mmHg. Body mass index and liver enzymes rose on placebo but not with the enzyme, and adverse events did not differ. The reductions were small and from a single trial.
Randomized, double-blind, placebo-controlled 12-week study of oral transglucosidase at 300 or 900 mg/day with fecal bacterial analysis; an author was from the enzyme maker Amano Enzyme (UMIN000010318). (Sasaki et al. 2013, BMC Gastroenterol)
60 patients with type 2 diabetes, plus 10 healthy individuals for comparison.
After 12 weeks the Bacteroidetes-to-Firmicutes ratio rose in the transglucosidase groups and was higher than placebo, while the overall bacterial communities were broadly similar before and after treatment. The authors concluded the enzyme lowered blood glucose and limited body-weight gain by producing oligosaccharides in the gut and shifting the microbiota. A small study from one research group.
Randomized, double-blind, placebo-controlled 12-week study of oral transglucosidase at 300 or 900 mg/day measuring bowel movements, fecal bacteria and short-chain fatty acids; an author was from the enzyme maker Amano Enzyme. (Shimozato et al. 2017, United European Gastroenterol J)
66 patients with type 2 diabetes.
The enzyme changed fecal bacteria and short-chain fatty acids, including a rise in acetate, and improved bowel movements versus placebo in the subgroup who began with a bowel-movement disorder (46.2% vs 0%); patients without a bowel problem at the start saw no change. The authors described the study as preliminary.
Controlled feeding experiment in healthy and streptozotocin-induced diabetic dogs given transglucosidase with maltose or dextrin on a high-fiber diet; an author was from the enzyme maker Amano Enzyme. This is animal research. (Sako et al. 2010, Vet Res Commun)
Five healthy and five diabetic dogs (animal study).
Adding the enzyme lowered mean post-meal blood glucose by about 13.8% when given with maltose and 23.9% when given with dextrin, compared with the diet alone, by converting starch into isomaltooligosaccharides. Findings in a handful of dogs may not carry over to people.